Provider Demographics
NPI:1508320946
Name:GONZALEZ, HIRAM MORALES
Entity Type:Individual
Prefix:
First Name:HIRAM
Middle Name:MORALES
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 CALLE ARAGUEZ
Mailing Address - Street 2:URB CIUDAD REAL
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-662-0122
Mailing Address - Fax:
Practice Address - Street 1:746 CALLE ARAGUEZ
Practice Address - Street 2:URB CIUDAD REAL
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-662-0122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program